MEDICARE: KRISTA E HUBER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	50.006542RX	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386259893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTA E HUBER PA-C

Provider Business Mailing Address
First Line	:	1140 S KNOXVILLE AVE STE D
Second Line	:
City	:	SAINT MARYS
State	:	OH
Zip	:	45885-2609
Country	:	US
Telephone Number	:	419-300-1129
Fax Number	:	419-394-9575

Provider Business Practice Location Address
First Line	:	1140 S KNOXVILLE AVE STE C1
Second Line	:
City	:	SAINT MARYS
State	:	OH
Zip	:	45885-2609
Country	:	US
Telephone Number	:	419-394-9595
Fax Number	:	419-394-9532

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2020
Last Update Date	:	04/06/2026

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Directions to “ KRISTA E HUBER PA-C” Practice Location

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